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Billing code 33390: Aortic valvuloplastyMedicare rate & RVUs

Open aortic valve valvuloplasty repairs a narrowed native valve while preserving it, typically during cardiac surgery using cardiopulmonary bypass.

CMS RVU26DEffective Oct 1, 2026109 payment localities289 Medicare services in 2024

Medicare pays $1,772.25 for 33390 nationally in a facility.

Medicare rate · 33390

Aortic valvuloplasty

Swap in your local Medicare rate.

Work RVUs
34.13
Total RVUs
53.06
Global days
090

National rate · 2026

$1,772.25

Facility setting, before claim adjustments.

See every locality for 33390 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 33390 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 33390 covers

This operation widens or repairs a narrowed native aortic valve while preserving the valve rather than replacing it. A cardiothoracic surgeon performs the repair in an operating room, commonly for aortic stenosis when the surgical plan is to improve valve opening. The procedure uses cardiopulmonary bypass. The operative report should describe the valve abnormality, repair performed, and surgical approach; code 33391 is the related transventricular approach.

Report 33390 when the documented procedure matches its open, bypass-supported approach. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces others to 50%. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 33390 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

33390 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,607.45
Alaska*Unavailable$2,240.67
ArizonaUnavailable$1,721.29
ArkansasUnavailable$1,587.62
AtlantaUnavailable$1,837.14
AustinUnavailable$1,763.46
BakersfieldUnavailable$1,719.44
Baltimore/Surr. CntysUnavailable$1,882.17
BeaumontUnavailable$1,720.62
BrazoriaUnavailable$1,717.12

33390 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
33390 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 33390 rate is calculated

Each of 33390’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 33390

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 34.13Practice expense 10.62Malpractice 8.31

53.0600 adjusted RVUs×$33.4009 conversion factor=$1,772.25

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 33390

33390 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33390

Aortic valvuloplasty

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 33390

Aortic valvuloplasty

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33390 without 51 · national facility

$1,772.25

Aortic valvuloplasty

33390-51 · Second procedure: 50%

$886.13

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

33390 compared with similar codes

Compare codes

33390 vs 33391 vs 33405 vs 33361: national Medicare rates

Swap in your local Medicare rate.

  • 33390
    Aortic valvuloplasty · 34.13 wRVU
    —
  • 33391
    Aortic valvuloplasty · 40.46 wRVU
    —
  • 33405
    Aortic valve replacement · 40.29 wRVU
    —
  • 33361
    TAVR · 21.91 wRVU
    —

How to choose

33391Aortic valvuloplasty
Both are open aortic valve valvuloplasty procedures with cardiopulmonary bypass. The documented transventricular approach distinguishes 33391.
33405Aortic valve replacement
33390 repairs the native aortic valve; 33405 is for replacing the valve.
33361TAVR
33361 describes transcatheter aortic valve replacement, not open surgical repair of the native valve.

Codes related to 33390

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 33390
CodeHow it relatesNational office range
Same family
33391Aortic valvuloplastyRelated open aortic valve valvuloplasty code for the documented transventricular approach.No office rate
Used instead
33405Aortic valve replacementOpen aortic valve replacement when the native valve is replaced rather than repaired.No office rate
33361TAVRTranscatheter aortic valve replacement, a different approach and replacement procedure.No office rate

33390 billing questions

How does 33390 differ from 33391?

Both describe open aortic valve valvuloplasty with cardiopulmonary bypass. Use 33391 when the operative report documents the transventricular approach; use 33390 for the other approach described by its code.

When should the repair be coded as valve replacement instead?

Use a replacement code when the surgeon removes or replaces the native aortic valve rather than repairing and preserving it. The operative report should establish which procedure was performed.

What documentation supports 33390?

Document the aortic valve condition, the repair performed, the open approach, and use of cardiopulmonary bypass. Include enough operative detail to distinguish the procedure from the transventricular approach represented by 33391.

How does the 90-day global period affect related care?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 33390PPRRVU2026_Oct_nonQPP.csv, line 3,933 (RVU26D)

Open CMS sourceHow we calculate rates

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